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2.
Hu Li Za Zhi ; 67(1): 75-83, 2020 Feb.
Artículo en Chino | MEDLINE | ID: mdl-32281085

RESUMEN

BACKGROUND: Face (self-esteem) is an issue that involves socially endowed status, identity roles, and self-image management and maintenance. People with dementia and their family members often experience social isolation due to diminished self-image, which affects disease progression. Better understanding the factors that influence the self-image of people with dementia may promote the ability of caregivers to maintain self-image and promote public understanding and empathy toward people with dementia. PURPOSE: The aim of this study was to explore the factors influencing self-image in people with dementia using a systematic review of the literature. METHODS: A systematic review was used. Articles were retrieved from electronic databases including PubMed, CINAHL, Airiti Library, and Cochrane Library. The following keywords and MeSH terms were used to search for articles on dementia, face, self-esteem, respect, and self-concept. A total of 3,050 articles published prior to September 2018 that matched the search criteria were extracted. After screening the topics, deleting repetitions, and doing critical appraisals, eight articles were selected for analysis. Research quality was appraised using the Joanna Briggs Institute and the Melnyk and Fineout-Overholt for Evidence-Based Medicine Level of Evidence. RESULTS: Two themes related to the factors influencing self-image in people with dementia were extracted from the selected articles. The first theme was "loss of self-identity". As people with dementia gradually lose their cognitive function and memory ability, they are increasingly incapable of handling and managing their current role tasks. The second theme was "negative public perception". The public believes that people with dementia are at risk to others and that their behaviors are unpredictable, resulting in the deprivation of the rights to which people with dementia are entitled. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Because of disease progression, people with dementia gradually lose their self-identity and become unable to perform their life-role tasks. This is accompanied by negative perceptions of the disease among the public, which, in turn, damages the self-image of people with dementia and their families. The results of this review may provide a reference for caregivers planning future person-centered care approaches for people with dementia. In addition, these results may help facilitate the establishment of a more friendly environment for people with dementia in both public and private spaces.


Asunto(s)
Demencia/psicología , Autoimagen , Cuidadores/psicología , Demencia/terapia , Empatía , Humanos
3.
PLoS Med ; 17(1): e1003016, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31917808

RESUMEN

BACKGROUND: Depression is associated with an increased risk of dementia. However, short follow-up times and lack of adjustment for familial factors in previous studies could influence this association. The purpose of the present study was to investigate the association between depression and subsequent dementia, while controlling for familial factors and with a follow-up of over 35 years. METHODS AND FINDINGS: Two cohorts were formed from all individuals aged 50 years or older living in Sweden as of 31 December 2005 (n = 3,341,010). The Swedish National Patient Register was searched from 1964 through 2016 to identify diagnosis of depression and dementia. In the first cohort, individuals diagnosed with depression (n = 119,386) were matched 1:1 with controls without depression diagnosis. The second cohort was a sibling cohort (n = 50,644) consisting of same-sex full sibling pairs with discordant depression status. In the population matched cohort study, a total of 9,802 individuals were diagnosed with dementia during a mean follow-up time of 10.41 (range 0-35) years (5.5% of those diagnosed with depression and 2.6% of those without depression diagnosis (adjusted odds ratio [aOR] 2.47, 95% CI 2.35-2.58; p < 0.001), with a stronger association for vascular dementia (aOR 2.68, 95% CI 2.44-2.95; p < 0.001) than for Alzheimer disease (aOR 1.79, 95% CI 1.68-1.92; p < 0.001). The association with dementia diagnosis was strongest in the first 6 months after depression diagnosis (aOR 15.20, 95% CI 11.85-19.50; p < 0.001), then decreased rapidly but persisted over follow-up of more than 20 years (aOR 1.58, 95% CI 1.27-1.98; p < 0.001). Also in the sibling cohort, the association was strongest in the first 6 months (aOR 20.85, 95% CI 9.63-45.12; p < 0.001), then decreased rapidly but persisted over follow-up of more than 20 years (aOR 2.33, 95% CI 1.32-4.11; p < 0.001). The adjusted models included sex, age at baseline, citizenship, civil status, household income, and diagnoses at baseline. The main limitation of the study methodology is the use of observational data; hence, the associations found are not proof of causal effects. CONCLUSIONS: Depression is associated with increased odds of dementia, even more than 20 years after diagnosis of depression, and the association remains after adjustment for familial factors. Further research is needed to investigate whether successful prevention and treatment of depression decrease the risk of dementia.


Asunto(s)
Demencia/diagnóstico , Demencia/epidemiología , Depresión/diagnóstico , Depresión/epidemiología , Anciano , Estudios de Cohortes , Demencia/psicología , Depresión/psicología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Suecia/epidemiología
4.
PLoS One ; 15(1): e0227857, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31940419

RESUMEN

BACKGROUND: Tailoring interventions to the needs of caregivers is an important feature of successful caregiver support programs. To improve cost-effectiveness, group tailoring based on the stage of dementia could be a good alternative. However, existing staging strategies mostly depend on trained professionals. OBJECTIVE: This study aims to stage dementia based on caregiver reported symptoms of persons with dementia. METHODS: Latent class analysis was used. The classes derived were then mapped with disease duration to define the stages. Logistic regression with receiver operating characteristic curve was used to generate the optimal cut-offs. RESULTS: Latent class analysis suggested a 4-class solution, these four classes were named as early (25.9%), mild (25.2%), moderate (16.7%) and severe stage (32.3%). The stages based on the cut-offs generated achieved an overall accuracy of 90.8% compared to stages derived from latent class analysis. CONCLUSION: The current study confirmed that caregiver reported patient symptoms could be used to classify persons with dementia into different stages. The new staging strategy is a good complement of existing dementia clinical assessment tools in terms of better supporting informal caregivers.


Asunto(s)
Cuidadores/psicología , Demencia/psicología , Pacientes/psicología , Anciano , Demencia/epidemiología , Demencia/fisiopatología , Familia/psicología , Femenino , Humanos , Análisis de Clases Latentes , Masculino , Persona de Mediana Edad
5.
Artículo en Alemán | MEDLINE | ID: mdl-31915864

RESUMEN

In March 2019 the Ethics Conference of the German Center for Neurodegenerative Diseases (DZNE) was held for the fifth time. It was organized by the DZNE Rostock/Greifswald site and chaired by Prof. Wolfgang Hoffmann. The conference provided scientists, physicians, representatives of the German Alzheimer Society, (informal) caregivers of people with dementia (PwD), and other interested people with the opportunity to talk about the opportunities and limitations of research on and for PwD.Nationally and internationally recognized experts on healthcare services research, clinical research, nursing research, (geriatric) psychiatry, interdisciplinary ageing research, economic law, and psychotherapy discussed the pros and cons of a multitude of topics like self-determination, research participant decree, informed consent, and participation of PwD in research. The aim of the event was to reconcile the view of practice pleading for an ethically correct, human treatment of PwD and respecting their autonomy with participation in (clinical) studies. Experts controversially discussed and consolidated different points of view of practice and research.


Asunto(s)
Demencia , Enfermedades Neurodegenerativas , Autonomía Personal , Anciano , Cuidadores , Demencia/psicología , Demencia/terapia , Alemania , Humanos , Enfermedades Neurodegenerativas/psicología , Enfermedades Neurodegenerativas/terapia
6.
Psychol Aging ; 35(1): 20-27, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31985246

RESUMEN

Having 2 or more relatives involved in the informal care of people with dementia is frequent worldwide. There are, however, few comparisons of primary and secondary caregivers and even fewer of those who are caring for the same person. Our study aimed to contrast these 2 experiences of caregiving. We compared 2 related samples of 61 primary and 61 secondary family caregivers of the same persons with dementia in a nonrandomized cross-sectional study. Caregivers' main outcome assessments were the Zarit Burden Interview (for subjective burden), the General Health Questionnaire (for psychological distress), and the Positive Aspects of Caregiving scale. We controlled for caregiver variables (e.g., demographics, caregiving arrangements, social support, sense of coherence) and the neuropsychiatric symptoms of dementia. Subjective burden was higher in primary than secondary caregivers (p = .013), but positive aspects of caregiving did not differ (p = .150). Psychological distress was high at clinically relevant levels in primary and secondary caregivers, without statistically significant differences between groups (p = .456). The findings demonstrate that notwithstanding the difficulties faced by primary caregivers, secondary caregivers may also experience clinically significant distress. Therefore, their needs for assistance and support should be addressed more systematically. These findings call for systemic family-focused interventions in dementia that address the support each person provides or might provide, as well as the psychological distress each person may feel. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Cuidadores/psicología , Apoyo Social , Adaptación Psicológica , Anciano , Envejecimiento , Estudios Transversales , Demencia/psicología , Femenino , Humanos , Masculino
7.
Psychol Aging ; 35(1): 41-54, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31985248

RESUMEN

Caregiver distress is a complex, multicausal phenomenon. Most of the available interventions for caregivers are protocolized or manualized. A case formulation approach may be more appropriate, as it provides the opportunity for assessing and treating specific dysfunctional mechanisms explaining each caregiver's needs and causes of distress, through the design of an individualized modular intervention. In the present study, a randomized controlled study has been done in which a functional analysis-guided modular intervention (FAMI) was developed. The FAMI was compared with two manualized intervention (cognitive-behavioral therapy and acceptance and commitment therapy) which have received preliminary support, and a control group (waiting list). Mixed-effect models and clinical significance analyses were performed. Results suggest that all the interventions were effective in reducing depressive and anxious symptomatology at postintervention assessment, with large effect sizes, and with reductions in depression being maintained at follow-up. Regarding anxiety, long-term effects have been found only for the FAMI intervention. Results also suggest positive effects associated with the FAMI intervention in the long term with regards to comorbidity between depressive and anxious symptomatology. FAMI presents great potential for reducing dementia caregivers' levels of distress, being especially effective in maintaining therapeutic effects in the long term. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Ansiedad/psicología , Cuidadores/psicología , Demencia/terapia , Depresión/psicología , Demencia/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad
8.
Psychol Aging ; 35(1): 55-77, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31985249

RESUMEN

This systematic review and meta-analysis compared the effects of 131 randomized controlled trials, published between 2006 and mid-2018, for dementia caregivers with community-dwelling care-recipients. A new classification of interventions was proposed to enable a more detailed examination of the effectiveness of psychological interventions; 350 postintervention effect sizes in 128 studies and 155 follow-up effect sizes in 55 studies were computed. Postintervention effects were significant for all outcomes when all interventions are pooled together. Follow-up effects were found for all outcomes, except physical health and positive aspects of caregiving. Educational programs with psychotherapeutic components, counseling/psychotherapy, and mindfulness-based interventions had the strongest effects on reducing depressive symptoms. Multicomponent and miscellaneous interventions had the largest effects on reduction of burden/stress. Multicomponent and mindfulness-based interventions had the largest effects on enhancing subjective well-being. It should be noted that mindfulness and counseling/psychotherapy studies generally had small samples, and studies with smaller sample sizes tended to report larger effects. Metaregression analyses revealed that, overall, younger caregivers benefited more from the interventions. Although the majority of studies were from North America and Europe, there were a growing number from Asia and other parts of the world. Recommendations were made, including developing new theoretical models that address caregivers' changing needs over time; development of interventions that can be flexibly administered and individually "tailored," and assessing positive as well as negative aspects of caregiving to encourage development of greater resilience. We conclude with observations on the global health significance of improving the impact of psychosocial interventions on caregivers' lives. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Cuidadores/psicología , Demencia/terapia , Demencia/psicología , Humanos , Persona de Mediana Edad
9.
PLoS One ; 15(1): e0227681, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31940401

RESUMEN

BACKGROUND: Older adults with Alzheimer's disease and related dementias (ADRD) are high-risk to experience hospitalizations and emergency room (ER) admissions. Mexican-Americans have a high prevalence of ADRD, but there is limited information on the healthcare use of older Mexican-Americans with ADRD. We used data from a cohort of older Mexican-Americans that has been linked with Medicare files to investigate differences in hospitalizations, ER admissions, and physician visits according to ADRD diagnosis. We also identify sociodemographic, health, and functional characteristics that may contribute to differences in healthcare utilization between Mexican-American Medicare beneficiaries with and without an ADRD diagnosis. METHODS AND FINDINGS: Data came from the Hispanic Established Populations for the Epidemiological Study of the Elderly that has been linked with Medicare Master Beneficiary Summary Files, Medicare Provider Analysis and Review files, Outpatient Standard Analytic files, and Carrier files. The final analytic sample included 1048 participants. Participants were followed for two years (eight quarters) after their survey interview. Generalized estimating equations were used to estimate the probability for one or more hospitalizations, ER admissions, and physician visits at each quarter. ADRD was associated with higher odds for hospitalizations (OR = 1.65, 95%CI = 1.29-2.11) and ER admissions (OR = 1.57, 95%CI = 1.23-1.94) but not physician visits (OR = 1.23, 95%CI = 0.91-1.67). The odds for hospitalizations (OR = 1.24, 95%CI = 0.97-1.60) and ER admissions (OR = 1.27, 95%CI = 1.01-1.59) were reduced after controlling for limitations in activities of daily living and comorbidities. CONCLUSIONS: Mexican-American Medicare beneficiaries with ADRD had significantly higher odds for one or more hospitalizations and ER admissions but similar physician visits compared to beneficiaries without ADRD. Functional limitations and comorbidities contributed to the higher hospitalizations and ER admissions for older Mexican-Americans with ADRD.


Asunto(s)
Americanos Mexicanos/psicología , Aceptación de la Atención de Salud/psicología , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/psicología , Estudios de Cohortes , Comorbilidad , Demencia/diagnóstico , Demencia/psicología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Medicare/estadística & datos numéricos , Persona de Mediana Edad , Pacientes Ambulatorios , Estados Unidos
10.
Z Gerontol Geriatr ; 53(2): 123-128, 2020 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-31965285

RESUMEN

BACKGROUND AND OBJECTIVE: The aim of the study was to evaluate a specific treatment concept for patients suffering from dementia in a geriatric day clinic with respect to improvement of dementia-related behavioral abnormalities and effects on distress of the caring relatives. MATERIAL AND METHODS: Designed as a naturalistic study with a sample of 34 dementia patients (average age 83 years, 62% female, 82% mild dementia, 18% moderate dementia) surveyed at three time points, the dementia-related behavioral symptoms and the relatives' distress were measured using the neuropsychiatric inventory. A waiting time before treatment was implemented as a control condition. RESULTS: Compared with waiting time, a significant improvement of dementia-related behavioral abnormalities was found after treatment, especially in patients suffering from moderate dementia. The distress of caring relatives was clearly reduced. CONCLUSION: The interprofessional treatment of patients with dementia using a specific program in a geriatric day clinic leads to a clear improvement in behavioral symptoms and positively influences the distress of caring relatives.


Asunto(s)
Síntomas Conductuales/complicaciones , Cuidadores/psicología , Demencia/terapia , Servicios de Salud para Ancianos/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Síntomas Conductuales/terapia , Demencia/diagnóstico , Demencia/psicología , Femenino , Humanos , Masculino , Resultado del Tratamiento
11.
Arch Gerontol Geriatr ; 86: 103955, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31561064

RESUMEN

BACKGROUND: Increased awareness of the clinical course of nursing home residents with advanced dementia and advance care planning (ACP) has become the cornerstone of good palliative care. OBJECTIVE: The aim of our study is to describe changes in ACP in the form of physician treatment orders (PTOs), symptom prevalence and possible burdensome interventions among nursing home (NH) residents who died between 2004-2009 and 2010-2013 METHODS: Retrospective study RESULTS: The number of PTOs regarding forgoing antibiotics or parenteral antibiotics, forgoing artificial nutrition or hydration or forgoing hospitalisation doubled between 2004-2009 and 2010-2013 (38.1% vs. 64.9%, p < 0.001; 40.0% vs. 81.7%, p < 0.001; 28.1% vs. 69.5%, p < 0.001, respectively). PTOs were also done significantly earlier in 2010-2013 than in 2004-2009. The prevalence of distressing symptoms and possible burdensome interventions remained unchanged, although the prevalence of consistency with the PTOs was high. CONCLUSION: Despite the increased number of PTOs, this had little effect on symptom prevalence and possible burdensome interventions experienced by NH residents in the last days of life.


Asunto(s)
Planificación Anticipada de Atención/tendencias , Directivas Anticipadas/estadística & datos numéricos , Demencia/terapia , Casas de Salud/estadística & datos numéricos , Cuidados Paliativos/estadística & datos numéricos , Cuidado Terminal/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Muerte , Demencia/mortalidad , Demencia/psicología , Femenino , Finlandia/epidemiología , Hogares para Ancianos/estadística & datos numéricos , Hospitalización , Humanos , Masculino , Prevalencia , Estudios Retrospectivos
12.
J Clin Nurs ; 29(1-2): 20-30, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31531993

RESUMEN

AIM: To explore the impact of cultural beliefs of dementia as witchcraft in sub-Saharan Africa. BACKGROUND: The population of sub-Saharan Africa is ageing, which increases the number of those at risk of dementia. Mental health and physical diseases that affect behaviour have often been associated with witchcraft. Accusations of witchcraft leave individuals vulnerable and at risk. METHOD: A systematic review, which followed the Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and completed a PRISMA checklist. CINAHL, PsycINFO, Web of Knowledge, PubMed and Science Direct databases were searched for relevant studies published from their inception to 31 May 2019 by applying appropriate Medical Subject Headings. Data analysis adhered to Thomas and Harding's thematic synthesis. RESULTS: The review identified limited literature on this topic, with only five papers meeting the inclusion and exclusion criteria. Studies explored health provision, and knowledge and beliefs of dementia in Tanzania and South Africa. Three themes emerged as follows: (a) poor knowledge of dementia, including the belief of dementia as witchcraft; (b) challenges of supporting a family member with dementia in the community; and (c) health-seeking behaviours of and for people with dementia. CONCLUSION: There remains a need for dementia awareness and education across sub-Saharan Africa communities, including faith and traditional healers, and healthcare professionals to support pluralistic healthcare provision. Nurses are the best-placed healthcare professionals to support these initiatives and the development and implementation of low-resource nonpharmacological interventions to support people with dementia and their families living in the community. RELEVANCE TO CLINICAL PRACTICE: Nurses working in sub-Saharan Africa and those caring for patients from sub-Saharan Africa can only provide person-centred care and support for a person with dementia and their family if they understand their cultural beliefs, one of which may include witchcraft.


Asunto(s)
Cuidadores/psicología , Demencia/enfermería , Hechicería/psicología , Asistencia Sanitaria Culturalmente Competente , Demencia/psicología , Familia/psicología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Sudáfrica , Tanzanía
13.
J Cross Cult Gerontol ; 35(1): 49-67, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31863260

RESUMEN

Resource constraints and high staff turnover are perceived as substantial barriers to high quality residential aged care. Achieving relationship-focused, person-centered care (PCC) is an ongoing challenge. This paper reports on an international project that explored how residential care leadership understand meaningful engagement for residents with dementia from culturally and linguistically diverse (CALD) backgrounds. This paper critically appraises the process, and outcomes, of an adapted Delphi method. Participants were the residential care leadership (i.e. staff in supervisory capacity) from four international facilities. Participation in the Delphi process was limited even though surveys were designed to require minimal time for completion. No participants opted for the alternative option of being interviewed. Findings indicate that residential care leadership recognised the importance of meaningful engagement for residents from CALD backgrounds. Limitations of time, resources and policy infrastructure were cited as barriers to achieving PCC. These findings suggest that facility leadership understand the importance of PCC, but identify multiple barriers rather than enablers for delivering PCC. Alternative methods, such as collecting data in interactive sessions allowing real-time discussion should be initiated to more effectively engage residential care leaders for a collaborative approach to explore PCC practices.


Asunto(s)
Instituciones de Vida Asistida/normas , Diversidad Cultural , Demencia/psicología , Liderazgo , Atención Dirigida al Paciente/normas , Australia , Técnica Delfos , Humanos , Lingüística , Nueva Zelanda , Participación del Paciente , Sudáfrica , Reino Unido
15.
World Neurosurg ; 135: 188-191, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31863885

RESUMEN

CASE DESCRIPTION: An 82-year-old man with dementia, gait disturbance, and a small cerebral infarction owing to severe bilateral carotid artery stenosis was successfully treated with carotid artery stenting (CAS). Preoperative cerebral vascular reactivity was reduced in the bilateral cerebral hemispheres. We performed CAS to treat right internal carotid artery stenosis. Following CAS, cerebral vascular reactivity showed an increase in the bilateral cerebral hemispheres. Memory, fluency, and attention also showed improvement. CONCLUSIONS: This case illustrates the potential benefit of single-stage CAS for cognitive function in severe bilateral carotid artery stenosis without hyperperfusion syndrome.


Asunto(s)
Arteria Carótida Interna/cirugía , Estenosis Carotídea/cirugía , Cognición , Demencia/fisiopatología , Procedimientos Endovasculares/métodos , Stents , Acetazolamida , Anciano de 80 o más Años , Inhibidores de Anhidrasa Carbónica , Estenosis Carotídea/complicaciones , Estenosis Carotídea/fisiopatología , Estenosis Carotídea/psicología , Angiografía Cerebral , Infarto Cerebral/complicaciones , Infarto Cerebral/diagnóstico por imagen , Infarto Cerebral/fisiopatología , Infarto Cerebral/psicología , Demencia/complicaciones , Demencia/psicología , Imagen de Difusión por Resonancia Magnética , Humanos , Angiografía por Resonancia Magnética , Imagen por Resonancia Magnética , Masculino , Pruebas Neuropsicológicas , Imagen de Perfusión , Índice de Severidad de la Enfermedad , Tomografía Computarizada de Emisión de Fotón Único
16.
Hu Li Za Zhi ; 66(6): 54-65, 2019 Dec.
Artículo en Chino | MEDLINE | ID: mdl-31802455

RESUMEN

BACKGROUND: Day care centers provide supportive services to older individuals with disability and dementia. Those who suffer from cognitive impairment typically also suffer from depression. PURPOSE: To explore whether TimeSlips, a reminiscence creative storytelling approach, improves depressive symptoms and quality of life (QoL) in older individuals of day care centers who have mild to moderate cognitive impairment. METHODS: A randomized non-blind controlled trial design was conducted. A total of 20 older individuals who met the inclusion criteria were recruited and randomly assigned to the experimental group and control group using the Internet randomization system, with 10 subjects in each group. The experimental group participated in the one-hour TimeSlips intervention once a week for six consecutive weeks, while the control group maintained their normal daily activities. We used the Cornell Scale for Depression in Dementia (CSDD) to measure depressive symptoms and used EQ-5D (EuroQol-5 dimensions) VAS (visual analogue scale) and utility values to measure QoL. RESULTS: (1) With the exception of age, there were no significant differences in the demographic data between two groups. (2) Under ANCOVA, when age was used as the covariate and the change in CSDD before and after the intervention was used as the dependent variable, the score of the experimental group was significant lower than that of the control group (p < .05). The interaction between group and age was also a significant difference in the change of CSDD before and after the intervention (p < .05). In terms of QoL, the EQ-5D VAS and EQ-5D utility value both decreased after the intervention in the experimental group. ANCOVA was performed separately using the change of EQ-5D VAS and the ranked change of EQ-5D utility values as dependent variables, with no significant differences found between the groups (p = .37 and p = .20, respectively). CONCLUSIONS: The results indicate that using TimeSlips may significantly improve depressive symptoms in mild to moderate cognitively impaired older individuals of day care centers. However, no evidence was found to support an effect of TimeSlips on QoL. Our findings provide information to help day care centers staffs design related activities.


Asunto(s)
Demencia/psicología , Demencia/terapia , Depresión/psicología , Narración , Calidad de Vida , Anciano , Centros de Día , Humanos , Resultado del Tratamiento
17.
Soins Gerontol ; 24(140): 29-31, 2019.
Artículo en Francés | MEDLINE | ID: mdl-31806175

RESUMEN

Managing aggression and agitation in elderly people with dementia can be seen from the perspective of certain conditions. Some therapies, particularly the use of neuroleptics, should be avoided. The need to put limits on non-pharmacological treatments must be emphasised.


Asunto(s)
Agresión , Demencia , Anciano , Demencia/complicaciones , Demencia/psicología , Humanos , Agitación Psicomotora
18.
Gerokomos (Madr., Ed. impr.) ; 30(4): 176-180, dic. 2019. graf, tab
Artículo en Español | IBECS | ID: ibc-188205

RESUMEN

Introducción: Las respuestas de los profesionales de los centros de cuidados de larga duración ante la manifestación de comportamientos sexuales en residentes son muy variadas, primando actitudes y prácticas negativas. Además, su nivel de conocimientos en este tema es bastante limitado. Objetivos: Sintetizar y analizar la evidencia disponible acerca de las percepciones de los profesionales sobre la sexualidad en personas mayores institucionalizadas en centros de cuidados de larga duración. Métodos: Revisión sistemática de artículos cualitativos publicados en inglés o castellano hasta mayo de 2017 en Medline, Scopus, Web of Science, Consejo Superior de Investigaciones Científicas, CUIDEN, ProQuest, PsycINFO y CINHAL que indagaran en las percepciones de los profesionales sobre la sexualidad en personas mayores institucionalizadas. Resultados: Seis artículos cumplieron los criterios de inclusión. Las siguientes categorías explicaban las percepciones de los profesionales sobre la sexualidad: la influencia de estereotipos negativos, la presión de las reacciones e interpretaciones profesionales, la interferencia familiar, la necesidad de privacidad, la necesidad de regular la expresión sexual y el manejo de la sexualidad en personas con demencia, lesbianas, gais o bisexuales. Conclusiones: Existe una falta de respuesta estándar, de conciencia y de conocimientos de los profesionales ante las situaciones sexuales en personas mayores institucionalizadas. Es necesario establecer directrices que promuevan un enfoque común en los centros y la reducción de prácticas potencialmente perjudiciales


Introduction: Long-Term Care workers responses to the manifestations of residents' sexual behavior are very varied, prevailing negative attitudes and practices. Moreover, their level of knowledge in this subject is quite limited. Objectives: To synthesize and analyse the available evidence regarding professionals' perceptions about the sexuality of institutionalized older people in Long-Term Care institutions. Method: A systematic search of articles published in English or Spanish exploring the perceptions of professionals about the sexuality of institutionalized older people was carried out until May 2017 in Medline, Scopus, Web of Science (WOS), Consejo Superior de Investigaciones Científicas (CSIC), CUIDEN, ProQuest, PsycINFO, and CINHAL. Results: Six studies met the inclusion criteria. Professionals' perceptions were grouped in the following categories: the influence of negative stereotypes, the pressure of professionals' reactions and interpretations, family interference, need for privacy, need for regulation of sexual expression and the management of sexuality in people with dementia, lesbian, gay or bisexual. Conclusion: There are a lack standard response and awareness and a knowledge gap of professionals in response to sexual situations in institutionalized older people. It is necessary to establish guidelines promoting a common approach in the institutions and a reduction of harmful practices


Asunto(s)
Humanos , Salud del Anciano Institucionalizado , Sexualidad , Hogares para Ancianos , Actitud del Personal de Salud , Investigación Cualitativa , Confidencialidad , Privacidad , Conducta Sexual , Demencia/psicología
20.
Dtsch Med Wochenschr ; 144(25): 1810-1815, 2019 12.
Artículo en Alemán | MEDLINE | ID: mdl-31847018

RESUMEN

Dementia as a multi-facetted ailment demands multimodal approaches. Music Therapy has gained sufficient evidence as therapeutic concept in many areas of traditional medicine. Standards for research, methods and quality of application are established. For people suffering from dementia music offers a variety of beneficial effects, especially enhancing communication and quality of life. Care givers appreciate relief in emotionally aversive situations as well.


Asunto(s)
Demencia , Musicoterapia , Música/psicología , Calidad de Vida , Anciano , Cuidadores , Demencia/psicología , Demencia/terapia , Humanos
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